Toronto, December 24, 2015. Complex. Complicated. Unique. If I had a dollar for every time I have heard these 3 words in the last month…
Every doctor and health professional I have seen has uttered these words several times as they review my case, examine me, discuss treatment options and share their concerns. 3 cancers within 3.5 years is rather unusual, particularly when there is no history of cancer in my immediate family.
This past Friday, we had a meeting with a Medical Oncologist at North York General Hospital, Dr. Danny Robson. Curly, disheveled hair with an inquisitive demeanor, Dr. Robson quickly digested my medical history, cutting through the noise and focusing on the facts of my current situation.
We sat in the sterile hospital room, anxious to hear the results, clinging on to every word. For any cancer patient, the worst word in the English language is “metastasis”. It means that the cancer has spread from the initial site to another part of the body, making it nearly impossible to treat. We were hoping that this was not the case for me. Because if it was, it would be brutal news to accept.
Dr. Robson began: The bone scan showed regular degeneration consistent with the presence of multiple myeloma (which we expected). The CT scan showed that the cancer had not spread to any other part of the body (beyond the one or two lymph nodes in my underarm). When we got this news, Shayne, Sabrina, Nagib and I took a collective sigh of relief — until then, we had not realized that we were holding our breath.
He then proposed a treatment plan. If I were not complex, complicated and unique, the plan would be 4 months of chemotherapy, a break for a month, surgery to remove the lump and some lymph nodes, followed by radiation – a “typical” approach for a diagnosis of early stage breast cancer.
Dr. Robson, however, expressed concern that chemotherapy would wear down my bone marrow and compromise my ability to deal with the multiple myeloma, including jeopardizing the second stem cell transplant that I will eventually need when the myeloma comes back.
In his view, I should have the surgery first and then, based on the outcome of the surgery, the medical team will determine the need, benefit and downstream implications of additional treatments, such as hormone therapy, radiation and, if necessary, chemotherapy. Dr. Tiedemann, with the support of the Breast Cancer team at Princess Margaret Cancer Centre, is weighing in on the decision making process (a second opinion of sorts), which gives me a lot of comfort. We hope to confirm the plan and begin prepping for treatment at my next appointment on December 29th at North York General Hospital.
As the Premji clan debriefed the hospital visit over breakfast and discussed our thoughts and fears openly, Sabrina equated my situation over the past few years to the weather system: most days have been delightfully sunny; others, cloudy with scattered showers. And even when we have been in the trenches, battling the thundershowers, the sun always found a way to peek through and clear the rain. My latest diagnosis of breast cancer means a rainstorm is in the forecast. Rather than fighting it or complaining about it, we’re all going to pull up our rain boots, get out our umbrellas and face the storm…and knowing us, we’ll probably splash in a few puddles and sing in the rain along the way! Because we know, the sun will come soon. It always does.
Merry Christmas everybody! Wishing you a very happy and extremely healthy holiday season.